| With the rapid development of economic society and the continuous deepening of reform the medical and health systems,the medical service quality has become an important foundation and guarantee of the hospital core competitiveness.The comprehensive evaluation of hospital medical service quality is convenient to find problems,and promote the improvement of medical service.The secondary comprehensive hospital is a key hub of China's medical service system,a bridge connecting the upper and lower medical service institutions.It is playing the main role of medical service.It is particularly important to strengthen the research on the medical service quality of secondary comprehensive hospitals.For the evaluation of medical service quality in secondary comprehensive hospitals,there is not yet an authoritative and universal mainstream indicator system.The evaluation model is less.It is of great significance to construct a scientific,reasonable,simple and applicable evaluation model of medical service quality of secondary general hospital,and make a comprehensive evaluation of it.Evaluation model of medical service quality can be find out the problems existing in hospitals and clinical departments,and put forward corresponding countermeasures and measures to improve the medical service quality of hospitals.Objective:To construct a scientific and applicable evaluation model of medical service quality of secondary comprehensive hospital.Through the empirical comprehensive evaluation of the medical service quality of the secondary general hospital,the problems existing in the hospital and clinical departments were found out.Corresponding countermeasures and measures were proposed,which provided a strong basis for the hospital to improve the medical quality and scientific management decisions.As well as,Evaluation model of medical service quality can reference for the evaluation of the medical service quality of similar hospitals.Methods:Through literature research and expert consultation,a comprehensive evaluation model for the medical service quality of secondary comprehensive hospitals was constructed.Through field investigation,medical service quality indicators of 8 major clinical departments(Department ? of medicine,Department ? of medicine,Department?of surgery,Department?of surgery,Department of gynaecology and obstetrics,Department of orthopedics,ENT,Department of infectious disease)of a secondary general hospital were obtained from 2012 to 2017.The descriptive statistical analysis was conducted.The quality of medical service in the hospital and clinical departments were evaluated by using TOPSIS.The problems and improvement measures of medical service quality in the hospital and clinical departments were put forward.Results:First,constructing the comprehensive evaluation model of medical service quality of secondary general hospital.At the beginning of the five dimensions of 28 evaluation indicators based on medical service quality evaluation model,expert's evaluation results: the number of asylum,number of emergency patients,surgical complications,sterile wound infection rate,preoperative diagnosis coincidence rate after operation,clinical diagnosis and pathological diagnosis coincidence rate,operation mortality indicators score are respectively 10.83±1.95 ?10.00±2.30?10.00±2.00?10.17±1.85?9.25±0.97?9.67±1.56?8.25±1.22.The average score of the other indicators was above 12.The final evaluation model has formed 21 evaluation indexes including 5 dimensions of work intensity,work efficiency,medical quality,medical cost and service quality.Second,current situation of medical service quality in hospitals from 2012 to 2017: the number of outpatient visits increased from 78,864 to 110,176;The number of inpatients increased from 8225 to 8380.The number of operations increased from 3816 cases to 3846 cases,and the utilization rate of beds decreased from 68.85% to 52.47%.The average length of stay decreased from 11.05 days to 9.26 days.Turnover of beds increased from 28.49 to 29.97;The 3-day diagnosis rate increased from 90.91% to 95.50%.The success rate of hospitalization was increased from 25.0% to 43.9%.The nosocomial infection rate decreased from 2.445% to 0.233%.The proportion of drugs decreased from 38.0% to 26.5%;The average cost of each hospitalization rose from $5,083 to $6,394.The patient service satisfaction rate increased from 95.75% to 99.65%.(3)the comprehensive evaluation found that the overall quality of medical service in this hospital was on the rise from 2012 to 2017,but it was the worst in 2015,followed by 2012.The average order of service quality of eight clinical departments in the same year was as follows: 1.83 in outer department,2.67 in orthopedics,3.33 in outer department,4.17 in five senses,5.67 in inner department,5.67 in inner department,and 6.67 in infection department.Service quality of the same clinical department in different years: continuous improvement and steady improvement of the medical service quality;Five departments of the department of internal medicine,external medicine,obstetrics and gynecology,facial features and infection were slightly increased in fluctuation.The second degree and orthopaedics showed significant decrease in fluctuation.Conclusion:(1)a comprehensive evaluation model of medical service quality of secondary comprehensive hospital with 21 evaluation indexes of 5 dimensions was constructed.(2)2012-2017,the hospital medical service quality status: positive indicators including outpatient clinic visits,hospital visits,surgical cases,diagnosis rate,three days hospital rescue success rate,service satisfaction rate were increased in patients with,dischargee average shortening of such confinement,bed turns speeding up,the nosocomial infection rate and drug than down.Adverse indicators include a decrease in bed occupancy,an increase in hospital charges and an increase in patient mortality.It can be seen that to strengthen the management of bed use,effectively reduce the cost of inpatients,and prevent the low-risk death of the hospital should be included in the management of the hospital.(3)comprehensive evaluation: the overall quality of medical service in the hospital has been on the rise in the past six years,but it was the worst in 2015,with the emphasis on the high per capita hospitalization cost and mortality rate.The service quality of the 8 clinical departments in the same year was basically good with "external first,orthopedics and external second",mainly due to the large workload,high work efficiency and good medical quality,while "internal first,internal second and infection department" was poor,mainly due to low efficiency,relatively poor medical quality and small workload of infection department.In the six years,the quality of medical services in the department of internal medicine continued to improve,and all indicators developed uniformly,while the fluctuation of "internal medicine,external medicine,obstetrics and gynecology,facial features and infection department" was relatively small,while the medical quality in the department of orthopedics and foreign medicine was unstable,with the focus being on the mortality rate and success rate of rescue.It can be seen that strict medical service quality,with work efficiency and medical quality as the core link and the other two as the focus,is the key to improve the medical service quality of the hospital. |
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